The treatment of perineal descent syndrome includes non-surgical treatment and surgical treatment, the specific content is as follows:
First, Non-surgical Treatment
1. Develop good defecation habits: Develop a good habit of regular defecation, avoid excessive straining during defecation, and avoid spending too much time on each defecation, which is better not to exceed 10 minutes; fiber preparations can be appropriately used to help defecation, thereby avoiding further damage to the pelvic floor muscles.
2. Strengthen anal exercises: The function of the pelvic floor muscles is mainly reflected in the contraction and relaxation of the anus. This movement is coordinated by the internal and external anal sphincters, levator ani muscles, and other muscles through complex mechanisms. Exercise methods can be adopted in supine knee position or other positions,配合 breathing and levator ani muscle movement, inhale when the pelvic floor muscles contract and exhale when they relax. This alternating contraction and relaxation is the basic method to alleviate perineal descent and restore the tension of the pelvic floor muscles.
3. Aggressive treatment of associated lesions: To alleviate symptoms and prevent further injury to the pelvic floor muscles, active treatment of prolapse should be given to patients with perineal descent syndrome accompanied by rectal intussusception or rectal prolapse. The aim is to break the vicious cycle between perineal descent syndrome, excessive straining during defecation, and prolapse. The first line of treatment is injection therapy, followed by strengthening anal exercises, which have been shown to be effective.
Second, Surgical Treatment
For those who are ineffective after injection treatment or have rectal intussusception inside the anal canal, surgical correction of rectal intussusception can be performed. However, due to pelvic floor muscle dysfunction associated with perineal descent syndrome, even after transabdominal rectal fixation or suspension surgery, some symptoms may still remain postoperatively.
Since perineal descent syndrome is accompanied by some degree of pelvic floor muscle dysfunction, clinical physicians should avoid performing anal dilation treatment to prevent further damage to the sphincter muscles and postoperative anal incontinence.